Conventional Fix Brace
Fixed braces are the most common type of orthodontic appliance. They can be used when a number of teeth need to be corrected, or when the treatment needs to be precise to prevent problems in the future.
- Conventional metal fixed appliances
- Ceramic fixed appliances
- Self-ligating fixed appliances
Orthodontic treatment uses appliances to correct the position of the teeth.
The four main types are:
- fixed braces – a non-removable brace made up of brackets that are glued to each tooth and linked with wires
- removable braces – usually plastic plates that cover the roof of the mouth and clip on to some teeth; they can only carry out very limited tooth movements
- functional appliances – a pair of removable plastic braces that are joined together or designed to interact together, and fit on to the upper and lower teeth
- headgear – this isn’t an orthodontic appliance itself, but can be used with other appliances and is usually worn at night
In more severe cases, treatment may involve fixed braces and surgery to move the jaw. This treatment is carried out in hospitals.
These are the most common form of appliance used in children and are often also termed 'train tracks'. They are most commonly made from stainless steel and attached onto the teeth using tooth coloured filling material (composite resin). Care has to be taken eating hard foods as the attachment can easily be broken leading to a disruption in treatment. An orthodontic wire (archwire) is tied (or ligated) into the bracket using coloured elastic rings which can discolour in-between visits.
These elastics can be silver coloured to blend in which the appliance or brightly coloured. As treatment progresses the orthodontist will progress to thicker wires which can place greater forces onto the teeth. Some patients term this process as 'tightening' the appliance. Appliances can easily be removed at the end of treatment leaving the teeth intact.
Rather than using stainless steel, the attachments may be made from a hard ceramic material to blend in with the tooth colour. This produces a more aesthetically pleasing appliance which is more of an attractive option, particularly for adults. The orthodontic wires can also be tooth coloured to help improve the appearance further. Ceramic fixed appliances can be as effective as conventional fixed appliances at achieving tooth movement. Sometimes they are not recommended for the lower teeth, if the bite is deep because the hard material can damage the opposing teeth that contact the attachments.
Ceramic appliances are slightly more difficult to remove than conventional fixed appliances, however, they are unlikely to damage healthy teeth in most cases. Any concerns should be discussed with your orthodontist.
All the main orthodontic manufacturers produce their own brand of self-ligating appliances, that may be metal or ceramic, and some may make substantive claims about their treatment benefit. Rather than using elastics to hold the orthodontic wire into position, these appliances have an integral clip mechanism that holds the wire which allows the wire to slide more freely. There is no evidence that this mechanism produces a more superior result than a conventional fixed appliance.
There is evidence that the time taken to change the wire is reduced with a self-ligating mechanism and there is less likelihood of the appliance discolouring in-between visits as no elastics are used to tie the wires.